Early reverse remodeling by echocardiography after transcatheter aortic valve implantation.

INTRODUCTION: Oslo University Hospital is a tertiary center conducting a significant number of transcatheter aortic valve implantation (TAVI) procedures per year. In this follow-up MediPace study, we aimed to investigate early echocardiographic changes in systolic and diastolic functions after TAVI in these patients. METHODS: All patients enrolled in the previous study were contacted 3 months after TAVI for echocardiographic evaluation. Detailed echocardiography was performed 3.5 ± 1.6 months after TAVI, and compared with baseline evaluations. RESULTS: A total of 101 patients were analyzed. Mean age was 80.1 ± 6.8 years and 40% of the patients were female. We observed a significant improvement in global longitudinal strain (GLS) (pre-TAVI -16.8 ± 4.1%, post-TAVI -17.8 ± 3.6%, p < .001), with no notable change in LVEF. More than half of the patients (52%) experienced a significant reverse remodeling with ≥10% decrease in left ventricular mass index (LVMi) following TAVI (pre-TAVI 123.6 ± 32.1 vs. 109.7 ± 28.9 g/m2 post-TAVI, p < .001). Pre-TAVI LVMi was a positive predictor, whereas history of HT was a negative predictor of LVMi reduction. There was no significant improvement in diastolic function following TAVI. Highest degree of paravalvular leakage was mild to moderate and was observed in only 2%. CONCLUSIONS: A significant improvement in GLS and LVMi was found following TAVI. History of hypertension and baseline LVMi were predictors of LVMi change. There was no notable change in diastolic function, including left atrial strain.

Pyrene Substituted Phthalonitrile Derivative As a Fluorescent Sensor For Detection of Fe3+ Ions in Solutions.

In this current study, the novel bis[4,5-(pyrene-2-yl)-3,6-(hexyloxy)] phthalonitrile (SPN) fluorophore has been successfully synthesized. Structural characterization of this novel compound was performed by different spectroscopic methods such as FT-IR, MALDI-TOF, 1H-NMR, 13C-NMR and elemental analyses as well. In addition, the photophysical properties were determined using UV-vis absorption, steady-state fluorescence, time-resolved fluorescence spectroscopic methods and quantum chemical calculations. The metal sensing behavior of the SPN was determined in the presence of various metals (Li+, Na+, K+, Mg2+, Ca2+, Ba2+, Mn2+, Fe3+, Cr3+, Co2+, Ni2+, Ag+, Cd2+, Al3+, Hg+ and Zn2+) using fluorescence spectroscopy. The novel pyrene based phthalonitrile (SPN) showed high sensitivity and selectivity towards Fe3+ ion over other examined metal ions. In order to perform the determination of Fe3+ ion in environmental samples, experimental conditions such as selectivity, stability, precision, sensitivity, accuracy and recovery were optimized. Also, the complex stoichiometry of the novel pyrene based phthalonitrile (SPN) and Fe3+ ions was determined by a Job's plot. The compound was also studied via density functional theory calculations revealing the interaction mechanism of the molecule with Fe3+ ions.

Experimental and theoretical investigation of water-soluble silicon(IV) phthalocyanine and its interaction with bovine serum albumin.

Photodynamic therapy (PDT) has drawn a great scientific attention to cancer treatment over the last decades. However, the bottleneck for the PDT is to find good photosensitizers (PSs) with greater water solubility, no aggregation, and fast discharge from the body. Therefore, there are still a big scientific desire for the synthesizing new rational PSs for treatment of cancer by PDT technique. In favor of improving the competence of PDT, an axially bis[4-(diphenylamino-1,1'-biphenyl-4-ol)] substituted silicon(IV) phthalocyanine (3) was converted to its water-soluble quaternized derivative (3Q). Their structures were fully characterized by single-crystal X-ray diffraction, elemental analysis, and different spectroscopic methods such as FT-IR, UV-Vis, MALDI-TOF, and 1H-NMR. The photophysical properties such as fluorescence quantum yields and lifetimes, and the photochemical properties such as singlet oxygen generation of both phthalocyanines were investigated. Ground and excited-state calculations were performed to explain the observed electronic absorption spectra. The addition of the 4-diphenylamino-1,1'-biphenyl-4-ol groups on the axially positions of the silicon(IV) phthalocyanine increased the singlet oxygen quantum yield from 0.15 to around 0.20. Especially quaternized compound 3Q showed high singlet oxygen quantum yield of 0.26 in water solution. In addition, a spectroscopic investigation of the binding behavior of the quaternized silicon (IV) phthalocyanine complex to bovine serum albumin (BSA) is also studied in this work, confirming the possible interaction. Further theoretical calculations were carried out to find out the plausible-binding regions of the BSA protein. Axially bis[4-(diphenylamino-1,1'-biphenyl-4-ol)] substituted silicon(IV) phthalocyanine (3) was converted to its quaternized water soluble derivative (3Q). The photophysical properties such as fluorescence quantum yields and lifetimes, and the photochemical properties such as singlet oxygen generation of both phthalocyanines were investigated. In addition, a spectroscopic investigation of the binding behavior of the quaternized silicon (IV) phthalocyanine complex to bovine serum albumin (BSA) is also studied in this work, confirming the possible interaction. Further theoretical calculations were carried out to find out the plausible binding regions of the BSA protein.

Protective Effect of Epigallocatechin Gallate in Ischemia-Reperfusion Injury of Rat Skeletal Muscle.

BACKGROUND: Reactive oxygen species-induced cell injury has been considered to be one of the main etiologic factors in ischemia-reperfusion injury (IRI). As a potential antioxidant agent, epigallocatechin gallate (EGCG) was examined in skeletal muscle of the rats after IRI with or without treatment. MATERIALS AND METHODS: Tourniquet application applied to the rats' hind limbs was selected as the appropriate IRI method. Animals were randomly distributed to one of the following groups: (1) sham control + SF (saline) (10 mg/kg/i.p.) (SC-SF), (2) IRI (4 + 2 h) + SF (10 mg/kg/i.p.) (IRI-SF), (3) IRI and EGCG (25 mg/kg/i.p.) (IRI-EG25), and (4) IRI and EGCG (50 mg/kg/i.p) (IRI-EG50). In another set of experiments with identical groups, the only difference was that the reperfusion period was 24 h. A number of different parameters relating to the damage seen in the skeletal muscles, lungs, kidneys, and liver and particular cytokines were measured by proper analytical methods. RESULTS: In comparison with the SC-SF group, IRI (4 + 2 h) induced an increase in the total oxidative status of skeletal muscle (10.17 ± 0.61 versus 15.74 ± 1.10) and blood creatine phosphokinase (CPK) (669.88 ± 50.23 versus 7202.38 ± 766.13) and lactate dehydrogenase levels (686.00 ± 67.48 versus 1343.00 ± 113.01). Although 25 mg/kg EGCG could not reverse these parameters to their normal levels, the higher dose of EGCG, that is, 50 mg/kg, was sufficient to prevent the increases seen in total oxidative status (8.55 ± 0.85) and CPK levels (4741.63 ± 339.40). In addition, reduced total antioxidant status of skeletal muscle in the IRI-SF group (0.50 ± 0.06) was elevated by the administration of EGCG (50 mg/kg) (0.85 ± 0.04). Regarding remote organ injury, only alanine transaminase (ALT) and aspartate transaminase (AST) levels were found to be increased, showing a slight damage in liver tissue. However, neither dose of EGCG was able to prevent this deleterious effect. As for cytokines (interleukin-1ß, IL-6, IL-8, tumor necrosis factor-α, and monocyte chemotactic protein-1), there were no differences between the study groups. In regard to long-term IRI (i.e., 4 + 24 h), statistically significantly elevated parameters in the IRI-SF group were as follows: CPK, lactate dehydrogenase, creatinine (Cr), and blood urea nitrogen. On the other hand, none of them were influenced by either dose of EGCG. According to the results, EGCG demonstrates a considerable protective effect toward IRI (4 + 2 h) of skeletal muscle. CONCLUSIONS: Although oxidative stress seems to play a significant role both in the pathogenesis of IRI and in the mechanism of action of EGCG, there is no evidence that inflammatory cytokines are, at least in our model, crucial mediators regarding the former events.

The role of omentin in early pregnancy losses.

This prospective case-control study aimed to investigate the role of omentin, an anti-inflammatory adipokine in early pregnancy losses. The study comprised 47 women with spontaneous miscarriage at a gestational age of 8-12 weeks and 36 healthy pregnant women, matched for age, body mass index and gestational age, gravdity and parity. A significant negative correlation was determined between plasma omentin concentrations and body weight (r= -0.242, p = .027) and gestational age (r= -0.249, p = .023). Although not statistically, the women with spontaneous miscarriage had higher plasma concentrations of omentin compared to those with healthy pregnancies (7.798 ± 3.453 ng/ml vs. 7.200 ± 3.442 ng/ml, p = .435). This finding might support the hypothesis that increased inflammation plays a role in the etiopathogenesis of early pregnancy losses. These results revealed the potential use of omentin to predict unhealthy pregnancies.Impact statementWhat is already known on the subject of the paper? The exact mechanism of early pregnancy loss with euploid foetal karyotype has not been elucidated yet. An alteration in the physiological inflammatory response of pregnancy might be one of the mechanisms responsible for miscarriage.What does this study add? To the best of our knowledge, this is the first study to investigate the role of omentin in early pregnancy loss. The results obtained from this current study could be used to clarify the relationship between inflammatory processes and miscarriage.What are the implications for clinical practice and/or further research? Identification of the role of omentin in the process of early pregnancy losses would be helpful in order to design further studies to determine the feasibility of using omentin as a serum marker to predict the risk of miscarriage in early pregnancies. Additionally, understanding of the etiopathogenesis of early pregnancy losses with euploid karyotype will give a lead to further researches which could focus on exploring new interventions to detect and treat altered inflammation in early pregnancies.

Utilization of lentil, pea, and faba bean hulls in Turkish noodle production.

Turkish noodles (eriste) were substituted with green lentil (Lens culinaris), red lentil (L. culinaris), faba bean (Vicia faba), and pea (Pisum sativum) hulls at the level of 2.5, 5, and 10% and the effects of the substitution on proximate composition, mineral composition, colour, cooking properties, thiamine and riboflavin contents, texture and sensory properties of the noodles were investigated. Crude ash, dietary fibre, Ca and Mg contents of the noodles significantly increased with pulse hull substitution regardless of the hull type compared to control. Lightness or brightness (L*) values of the noodles showed a general decreasing trend with increasing pulse hull substitution excluding pea hull. L* value of the pea hull substituted noodles was higher than that of the control. Water absorption and swelling volume of the noodles remarkably increased with pea hull substitution. Thiamine and riboflavin contents of the control noodles and the noodles substituted with the noted hull types up to 10% were very close to each other. Noodles substituted with faba bean hull at the level of 10% showed the highest hardness, gumminess, and chewiness values. Pea hull substitution up to 10% did not significantly affected the sensory (appearance, texture and overall acceptability) scores of the panellists.

Axially substituted silicon(IV) phthalocyanine and its quaternized derivative as photosensitizers towards tumor cells and bacterial pathogens.

Axially di-(alpha,alpha-diphenyl-4-pyridylmethoxy) silicon(IV) phthalocyanine (3) and its quaternized derivative (3Q) were synthesized and tested as photosensitizers against tumor and bacterial cells. These new phthalocyanines were characterized by elemental analysis, and different spectroscopic methods such as FT-IR, UV-Vis, MALDI-TOF and 1H NMR. The photophysical properties such as absorption and fluorescence, and the photochemical properties such as singlet oxygen generation of both phthalocyanines were investigated in solutions. The obtained values were compared to the values obtained with unsubstituted silicon(IV) phthalocyanine dichloride (SiPcCl2). The addition of two di-(alpha,alpha-diphenyl-4-pyridylmethanol) groups as axial ligands showed an improvement of the photophysical and photochemical properties and an increasement of the singlet oxygen quantum yield (ΦΔ) from 0.15 to 0.33 was determined. The photodynamic efficacy of synthesized photosensitizers (3 and 3Q) were evaluated with promising photocytotoxicity (17% cell survival for 3 and 28% for 3Q) against the cervical cancer cell line (HeLa). The photodynamic inactivation of pathogenic bacterial strains Streptococcus mutans, Staphylococcus aureus, and Pseudomonas aeruginosa suggested a high susceptibility with quaternized derivative (3Q). The both Gram-positive bacterial strains were fully photoinactivated with 11µM 3Q and mild light dose 50J.cm-2. In case of P. aeruginosa the effect was negligible for concentrations up to 22µM 3Q and light dose 100J.cm-2. The results suggested that the novel axially substituted silicon(IV) phthalocyanines have promising characteristic as photosensitizer towards tumor cells. The quaternized derivative 3Q has high potential for photoinactivation of pathogenic bacterial species.

Brugada syndrome, Brugada phenocopy or none?

Brugada syndrome is a form of inherited arrhythmia syndrome characterized by a distinct ST-segment elevation in the right precordial leads. Brugada phenocopies are clinical entities that present with an electrocardiographic pattern identical to Brugada syndrome and may obey to various clinical conditions. We present a case of a suicidal attempt using a high dose of propafenone causing a Brugada-type electrocardiographic pattern. Is this a Brugada syndrome case, a Brugada phenocopy or something else?

The effect of ultrasound on some properties of pulse hulls.

The aim of this study was to understand the effects of different ultrasound conditions on dietary fiber, phytic acid, total phenolics content, water and oil binding capacity, antioxidant capacity and phenolic acid composition of hull from green and red lentils (Lens culinaris), faba bean (Vicia faba), and pea (Pisum sativum). The highest and the lowest total dietary fiber content was observed in red lentil and faba bean hulls, respectively. Insoluble dietary fiber contents of the untreated pulse hulls were above 66% regardless of the pulse type. Phytic acid content of the pulse hulls ranged between 1.37 and 1.66 mg/g and was not affected from either the pulse type or ultrasound treatment. High and significant correlations were found between total phenolics content and Trolox equivalent antioxidant capacity both of which showed higher values for lentil hulls. Bound (hydrolyzable) extracts contained higher amounts of phenolic acids compared to free form extracts. Protocathechuic, p-coumaric and ferulic acids either in free or bound (hydrolyzable) form were present in hull from all the pulses. Ultrasound treated samples showed significantly lower total phenolic content and TEAC values compared to control for lentil hulls, while no consistent trend was observed for phenolic acids with regard to the ultrasound conditions.

Identifying optimal channels and features for multi-participant motor imagery experiments across a participant's multi-day multi-class EEG data.

The concept of the brain-computer interface (BCI) has become one of the popular research topics of recent times because it allows people to express their thoughts and control different applications and devices without actual movement. The communication between the brain and the computer or a machine is generally provided through Electroencephalogram (EEG) signals because they are cost-effective and easy to implement in normal life, not just in healthcare facilities. On the other hand, they are hard to process efficiently due to their nonlinearity and noisy nature. Thus, the field of BCI and EEG needs constant work and improvement. This paper focuses on generalizing the most efficient EEG channels and the most significant features of motor imagery (MI) signals by analyzing the recordings of one participant obtained over 20 different days. Because the classification performance usually decreases with an increasing number of class labels, we have realized the study by analyzing the signals through a new paradigm consisting of multi-class directional labels: right, left, forward, and backward. Afterward, the results are tested on EEG data obtained from 5 participants to see if the results are consistent with each other. The average accuracy of binary and multi-class classification using the Ensemble Subspace Discriminant classifier was found as 87.39 and 61.44%, respectively, with the most efficient 3-channel combination for daily BCI evaluation of one participant. On the other hand, the average accuracy of binary and multi-class classification was found as 71.84 and 50.42%, respectively, for 5 participants, with the most efficient channel combination of 4, where the first three are the same as the daily performance of one participant. During signal processing, the outliers of the signals were discarded by considering the channels separately. An algorithm was developed to dismiss the inconsistent samples within the classes. A novel adaptive filtering approach, correlation-based adaptive variational mode decomposition (CBAVMD), was proposed. The feature selection was realized based on the standard deviation values of the features between the classes. The paradigm based on the direction movements was found to be most effective, especially for binary classification of right and left directions. The generalization of effective channels and features was found to be generally successful.

Left ventricular mechanical dispersion as a predictor of the need for pacemaker implantation after transcatheter aortic valve implantation: MeDiPace TAVI study.

AIMS: Permanent pacemaker (PM) implantation is common after transcatheter aortic valve implantation (TAVI). Left ventricular mechanical dispersion (MeDi) by speckle tracking echocardiography is a marker of fibrosis that causes alterations in the conduction system. We hypothesized that MeDi can be a predictor of the need for PM implantation after TAVI. METHODS AND RESULTS: Consecutively, 200 TAVI patients were enrolled. Transthoracic echocardiography and electrocardiography examinations were recorded before TAVI to evaluate global longitudinal strain (GLS), MeDi, and conduction disturbances. PM implantation information was obtained 3 months after TAVI. Patients were stratified into PM or no PM group. Mean age was 80 + 7 years (44% women). Twenty-nine patients (16%) received PM. MeDi, QRS duration, existence of right bundle branch abnormality (RBBB), and first-degree atrioventricular (AV) block were significantly different between groups. MeDi was 57 ± 15 ms and 48 ± 12 ms in PM and no PM groups, respectively (P < 0.001). In multivariate analysis, MeDi predicted the need for PM after TAVI independently of GLS, QRS duration, RBBB, and first-degree AV block [odds ratio (OR): 1.73, 95% confidence interval (CI): 1.22-2.45] with an area under the curve (AUC) of 0.68 in receiver operating characteristic (ROC) curves. Moreover, RBBB was an independent predictor of PM need after TAVI (OR: 8.98, 95% CI: 1.78-45.03). When added to RBBB, MeDi had an incremental predictive value with an AUC of 0.73 in ROC curves (P = 0.01). CONCLUSION: MeDi may be used as an echocardiographic functional predictor of the need for PM after TAVI.

Synthesis, photo-physicochemical and biological properties of novel tetrahydropyrimidone-substituted metallo-phthalocyanines.

In this study, new peripherally substituted symmetric zinc and magnesium phthalocyanines (4 and 5) were successfully prepared by cyclotetramerization of the tetrahydropyrimidone (THPM)-linked phthalonitrile 3. The identity of the compounds were confirmed primarily through spectroscopic analysis including NMR, FT-IR, UV-Vis and MALDI-TOF mass spectroscopy. The photophysical and photochemical properties of the synthesized phthalocyanines (Pcs) were examined using UV-Vis absorption and fluorescence emission spectroscopy techniques. The quantum yields of singlet oxygen were found to be 0.50 and 0.33 for compounds 4 and 5 in DMSO, respectively. In addition to photo-physicochemical properties, the enhanced biological activities of compounds 4 and 5 were investigated using a range of biological assays, namely, antibiofilm, microbial cell viability, antioxidant, DNA cleavage, antimicrobial and photodynamic antimicrobial assays. The maximum DPPH inhibition of 4 and 5 was detected as 40.46% and 25.76% at 100 mg L-1, respectively. Fragmentation of the DNA molecule was observed at concentrations of 25 mg L-1, 50 mg L-1 and 100 mg L-1 for 4 and 5. Additionally, effective inhibition of microbial cell viability was observed with the targeted Pcs. The antibiofilm properties of these compounds were found to be concentration-dependent. The biofilm inhibition activities of 4 and 5 were found to be 96.01% and 92.04% for S. aureus, while they were 95.42% and 91.27%, for P. aeruginosa, respectively. The antimicrobial activities of 4 and 5 on different microorganisms were evaluated using the microdilution assay. In the case of photodynamic antimicrobial treatment, the newly synthesized Pcs showed more effective antimicrobial inhibition compared to the control. These findings suggest that compounds 4 and 5 can be used as promising photodynamic antimicrobial agents for the treatment of many diseases, particularly infectious diseases.

Refusal of the hospitalization: a distressed dilemma in obstetric practice.

Background: Pregnant women are a special population in which hospitalizations are more recommended due to physiological changes mimicking pathologies and medico-legal concerns. Objectives: We aimed to assess the obstetric outcomes of expectant mothers who were admitted to the obstetrics emergency outpatient clinic and declined the hospitalization advised by doctors. Additionally, we examined the appropriateness of physicians' recommendations. Design: We have retrospectively evaluated the patients admitted to the 'Obstetric Emergency Outpatient Clinic' and refused hospitalization between 1 January 2019 and 31 December 2019. Methods: Cases were classified into three groups based on the trimester, considering the substantial variation between complaints and complications in each trimester. The complaints of pregnant women were categorized as psychosocial causes, obstetric complications, maternal systemic complaints, and suspicion of labor. We evaluated the compatibility of the hospitalization decision with the pregnancy outcome of patients. Results: A total of 958 pregnant women were included in the study. Leading causes for admissions were obstetric complications, maternal systemic complaints, and suspicion of labor in first, second, and third trimesters, respectively. Psychosocial causes were mostly observed in the second trimester. Readmission to the hospital within a week was highest in the third trimester group. According to pregnancy outcomes, 12.5% (94/753) of our recommendations were appropriate in all trimesters. Conclusion: Obstetricians seem overcautious in managing obstetric patients and willing to offer hospitalization more often than the actual requirements.

Differential diagnosis of an osseous cranial tumor from Hellenistic Mugla, Turkey.

OBJECTIVE: This project evaluates a cranial lesion from a Hellenistic-era individual excavated by the Mugla Archaeological Museum in Gülagzi, Turkey. MATERIALS: An osseous tumor measuring 3.02 × 3.54 × 2.98 cm originating from the occipital bone of a probable young adult male. METHODS: The tumor was examined using gross morphological inspection, plain radiography (x-ray), and computed tomography (CT) imaging to identify potential differential diagnoses for the osseous cranial tumor. RESULTS: The lesion in question displays features highly consistent with both osteoid osteoma and osteoblastoma. The tumor had a non-sclerotic, sharply demarcated border, a radiolucent nidus measuring less than 2 centimeters in diameter, and homogeneous sclerotic bone surrounding the nidus. CONCLUSIONS: Differential diagnosis determined the osseous tumor to be a benign neoplasm, and in this case the features of the tumor are highly consistent with a diagnosis of either osteoblastoma or osteoid osteoma. SIGNIFICANCE: The identification of novel neoplastic cases in paleopathology represents an important contribution to ongoing discussions regarding the temporality and regional variability of neoplastic conditions in the past. Additionally, a rigorous diagnostic study augmented by x-ray, CT scans, and 3D modeling provides data that can be utilized in future paleopathological studies. LIMITATIONS: Diagnostic interpretation would be aided by histological examination of the tumor, which was impossible in this case. Histological examination would provide a definitive diagnosis. SUGGESTIONS FOR FURTHER RESEARCH: Given the high incidence of benign tumors in the clinical literature but a paucity of reports in the paleopathological record, further research is indicated to better understand the implications of benign neoplasms in antiquity.

International consensus statement on challenges for women in cardiovascular practice and research in the COVID-19 era.

The challenges to academic and professional development and career advancement of women in cardiology (WIC), imposed by the pandemic, not only impinge the female cardiologists' "leaky pipeline" but also make the "leakiness" more obvious. This consensus document aims to highlight the pandemic challenges WIC face, raise awareness of the gender equity gap, and propose mitigating actionable solutions derived from the data and experiences of an international group of female cardiovascular clinicians and researchers. This changing landscape has led to the need for highly specialized cardiologists who may have additional training in critical care, imaging, advanced heart failure, or interventional cardiology. Although women account for most medical school graduates, the number of WIC, particularly in mentioned sub-specialties, remains low. Moreover, women have been more affected by systemic issues within these challenging work environments, limiting their professional progression, career advancement, and economic potential. Therefore, it is imperative that tangible action points be noted and undertaken to ensure the representation of women in leadership, advocacy, and decision-making, and increase diversity in academia. Strategies to mitigate the negative impacts of the pandemic need to be taken during this COVID-19 pandemic to ensure WIC have a place in the field of Cardiology.

Chemosensor properties of 7-hydroxycoumarin substituted cyclotriphosphazenes.

The newly synthesized cyclotriphosphazene cored coumarin chemosensors 5, 6, and 7 were successfully characterized by 1 H NMR, 31 P NMR, and MALDI-TOF mass spectrometry. Additionally, the photophysical and metal sensing properties of the targeted compounds were determined by fluorescence spectroscopy in the presence of various metals (Li + , Na + , K + , Cs + , Mg 2+ , Ca 2+ , Ba 2+ , Cr 3+ , Mn 2+ , Fe 3+ , Co 2+ , Al 3+ , Hg + , Cu 2+ , Zn 2+ , Ag + , and Cd 2+ ) . The fluorescence titration results showed that compounds 5, 6, and 7 could be employed as fluorescent chemosensors for Fe 3+ ions with high sensitivity. The complex stoichiometry between final cyclotriphosphazene chemosensors and Fe 3+ ions was also determined by Job's plots.

Successful Coronary Flow Restoration by Stent-Free Strategy Using the Pull-Back Method of Cutting Balloon in Spontaneous Coronary Artery Dissection.

This report describes a 46-year-old woman with ST-elevation myocardial infarction due to spontaneous coronary artery dissection. Because continuous chest pain and ST-segment elevation in electrocardiography indicated ongoing cardiac ischemia, the urgent revascularization strategy was used using a novel method of cutting balloon angioplasty, "the pull-back of inflated cutting balloon," which led to the successful coronary flow restoration and complete healing of dissected coronary artery in 1 year. The pull-back of the inflated cutting balloon method is a useful therapeutic option in the treatment of patients with spontaneous coronary artery dissection with ongoing cardiac ischemia.

Le présent rapport décrit le cas d'une femme de 46 ans ayant subi un infarctus du myocarde avec élévation du segment ST dû à une dissection spontanée de l'artère coronaire (DSAC). Compte tenu de la douleur thoracique continue et de l'élévation du segment ST à l'électrocardiographie, signes indicateurs d'une ischémie cardiaque en cours, une revascularisation d'urgence a été employée à l'aide d'une nouvelle méthode d'angioplastie au ballon coupant. « La traction du ballon coupant gonflé ¼ a permis en l'espace d'un an de restaurer avec succès le débit coronarien et d'obtenir une cicatrisation complète de l'artère ayant subi la déchirure. La méthode de traction du ballon coupant gonflé s'avère une option thérapeutique utile dans le traitement des patients présentant une DSAC associée à des symptômes d'ischémie cardiaque.

Subclinical biventricular systolic dysfunction in patients with systemic sclerosis.

OBJECTIVE: Silent myocardial involvement is associated with poor prognosis in patients with systemic sclerosis (SSc). Here we aimed to evaluate the subclinical left ventricular (LV) and right ventricular (RV) systolic dysfunction in patients with SSc without any cardiovascular diseases, by using both strain imaging methods, speckle tracking echocardiography (STE) and real-time 3D echocardiography (RT3DE). METHODS: A total of 47 patients with SSc and 20 age- and gender-matched healthy controls (HC) were studied. Conventional echocardiography, STE-based strain imaging, and real-time 3D echocardiography (Bothell, WA, USA) were performed to assess the biventricular deformation. Clinical and serological findings were sought. RESULTS: Conventional echocardiographic LV measurements were similar between SSc and HC. Both the LV and RV longitudinal peak systolic strain/strain rates were significantly impaired in SSc, demonstrating subclinical LV and RV systolic dysfunction (p≤0.001). Systolic pulmonary artery pressure (SPAP) was negatively correlated with both the LV and RV longitudinal peak systolic strain/strain rates (LV, r=-0.554 and r=-0.642, respectively, p<0.001; and RV, r=-0.554 and r=-0.642, respectively, p=0.001). There was a trend for decreasing LV strain and increasing LEVSV in a 1-year analysis of patients with SSc. CONCLUSION: SSc is associated with myocardial systolic dysfunction. A deformation scrutiny conducted by both the STE-based strain imaging and end-systolic LV volume analysis by real-time 3D echocardiography are promising modalities that allow us for non-invasive, comprehensive investigation of subtle deterioration in the biventricular systolic function of patients with SSc.

Abdominal palpation and percussion maneuvers do not affect bowel sounds.

OBJECTIVES: Medical textbooks suggest that the frequency of bowel sounds may be altered by performing auscultation after palpation or percussion. We hypothesize that the frequency of bowel sounds is not affected by the order of abdominal examination. MATERIAL AND METHODS: Both healthy volunteers (n= 80) and patients (n= 100) were enrolled in this crossover randomized study. Two different examination orders, one as inspection, palpation, percussion, auscultation (IPPA) and the other order as inspection, auscultation, palpation, percussion (IAPP) were used by two observers, one of which was blinded to the order of the physical examination and only performed auscultation. Bowel motilities of 40 participants were analyzed with duplex Doppler USG by a radiologist. The effects of changing the order of abdominal examination and palpation-percussion maneuvers on the frequency of bowel sounds were evaluated. RESULTS: Gender distribution was similar between the healthy patients and controls, and mean age of the entire study population was 47 (18-60) years. Differences between the mean bowel sound frequencies for abdominal examinations in order IPPA-IAPP versus IAPP-IPPA were evaluated for both healthy subjects and the patients. There were no differences between the first and second listening, nor were there differences between examinations performed in either order. Duplex Doppler Ultrasonographic (USG) assessments were performed on 20 healthy subjects and 20 patients before and after palpation and percussion; there were no statistically significant differences between the two listenings (p= 0.694). CONCLUSION: According to both abdominal examinations and Doppler USG, the order of auscultation, whether performed before or after palpation or percussion, did not change the frequency of bowel sounds in this subject population.

Synthesis and organic solar cell performance of BODIPY and coumarin functionalized SWCNTs or graphene oxide nanomaterials.

The synthesis and characterization of new hybrid materials based on reduced graphene oxide (rGO) or single walled carbon nanotubes (SWCNTs) covalently functionalized by 4,4'-difluoro-8-(4-propynyloxy)-phenyl-1,3,5,7-tetramethyl-4-bora-3a,4a-diaza-s-indacene (BODIPY) (2) or 7-(prop-2-yn-1-yloxy)-3-(3',4',5'-trimethoxyphenyl)-coumarin (4) as light harvesting groups have been described. The organic solar cell performances of these novel nanomaterials in P3HT:PCBM blends were investigated. These covalently bonded hybrid materials (reduced graphene oxide:BODIPY (GB), reduced graphene oxide:Coumarin (GC), SWCNTs:BODIPY (CB) and SWCNTs:Coumarin (CC)) were prepared by an azide-alkyne Huisgen cycloaddition (click) reaction between the azide bearing SWCNTs or rGO and terminal ethynyl functionalized BODIPY (2) or coumarin (4) derivatives. The formation of novel nanomaterials was confirmed by FT-IR, UV-Vis and Raman spectroscopies and thermogravimetric analysis. The best performance on P3HT:PCBM organic solar cells was produced by SWCNTs:Coumarin (CC) hybrids which were coated on an indium tin oxide coated polyethylene terephthalate film (ITO-PET). The reference device based on the P3HT:PCBM blend without CC showed a power conversion efficiency (PCE) of 1.16%, an FF of 35% and a short-circuit current density (Jsc) of 5.51 mA cm-2. The reference device with CC hybrids within the P3HT:PCBM blend increased the values significantly to 1.62% for PCE, 40% for FF and 6.8 mA cm-2 for Jsc.